Zhang Yi-Xue, Tang Juan, Zhu Dan, Wu Chun-Yan, Liang Mei-Lan, Huang Yuan-Tao
Department of Healthcare, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou 570208, Hainan Province, China.
Department of Healthcare, Hainan Chengmei Hospital, Haikou 570000, Hainan Province, China.
World J Radiol. 2024 Sep 28;16(9):489-496. doi: 10.4329/wjr.v16.i9.489.
According to the population statistics in 2023, there were 110000 people aged over 100 years in China, and the experience of using Paxlovid (nirmatrelvir/ritonavir) for centenarians is particularly valuable. This article reports our experience of using Paxlovid in a centenarian with the novel coronavirus disease 2019 (COVID-19) infection.
A 103-year-old female with mild COVID-19 and renal insufficiency was given sufficient Paxlovid for 2 days and a half dose for 3 days. During treatment, the patient was complicated with lung infection and heart failure, and nucleic acid remained positive. After expert consultation, a full dose of Paxlovid was given again on the 9th day of admission for 2 days and a half dose for 3 days. Meanwhile, anti-heart failure and antibiotics were administered; the heart failure and pulmonary infection were improved. Finally, on the 33 day of admission, nucleic acid turned negative, body temperature returned to normal, cough and sputum, fatigue, poor appetite and other symptoms basically improved. The patient was given Paxlovid nasal feeding for 2 courses without deterioration of liver and kidney function, diarrhea, nausea and vomiting, myalgia, chest tightness and other side effects, and was discharged from hospital with good recovery.
This case suggests that Paxlovid can be used cautiously in centenarians with renal insufficiency and two courses of treatment can be considered in patients with persistent positive nucleic acid.
根据2023年人口统计数据，中国有11万100岁以上的老人，帕罗韦德（奈玛特韦/利托那韦）用于百岁老人的经验尤为宝贵。本文报告了我们在一名新型冠状病毒肺炎（COVID-19）感染的百岁老人中使用帕罗韦德的经验。
一名103岁患有轻度COVID-19且肾功能不全的女性，给予足量帕罗韦德2天，半量3天。治疗期间，患者并发肺部感染和心力衰竭，核酸仍为阳性。经专家会诊，入院第9天再次给予足量帕罗韦德2天，半量3天。同时给予抗心力衰竭和抗生素治疗；心力衰竭和肺部感染得到改善。最终，入院第33天，核酸转阴，体温恢复正常，咳嗽咳痰、乏力、食欲差等症状基本改善。患者给予帕罗韦德鼻饲2个疗程，未出现肝肾功能恶化、腹泻、恶心呕吐、肌痛、胸闷等副作用，康复良好出院。
该病例提示，肾功能不全的百岁老人可谨慎使用帕罗韦德，核酸持续阳性的患者可考虑两个疗程的治疗。
